[Assessment of surgical teleconsultations in a developing country: two years of experience in Djibouti].

Objective: Our objective was to assess the influence of teleconsultations on patient management and clinical outcomes in a developing country.

Materials And Methods: All the surgical teleconsultations by a single surgeon (orthopedist) between November 2009 and November 2011 were recorded.

Results: Neurosurgery and pediatric orthopedics were the two most important specialities most often concerned, accounting for 67% of the 157 teleconsultations for 138 patients.

Teleconsultation in paediatric orthopaedics in Djibouti: evaluation of response performance.

Background: Djibouti has no paediatric orthopaedics department and three options are available for difficult cases: transfer of the patient to another country; overseas mission transfer to Djibouti by a specialised surgical team; and management by a local orthopaedic surgeon receiving guidance from an expert. The extreme poverty of part of the population of Djibouti often precludes the first two options. Telemedecine can allow the local orthopaedic surgeon to receive expert advice.

Proximal femoral nail antirotation (PFN-ATM) fixation of extra-capsular proximal femoral fractures in the elderly: retrospective study in 102 patients.

Background: The best surgical strategy for extra-capsular proximal femoral fractures (PFFs) is controversial in the elderly. Poor bone quality and neck screw instability can adversely affect the results with currently available fixation devices, which predominantly consist in dynamic hip screw-plates and proximal reconstruction nails.

Hypothesis: The helical blade of the proximal femoral nail antirotation (PFN-A™) achieves better cancellous bone compaction in the femoral neck, thereby decreasing the risk of secondary displacement.

[A prosthetic joint infection caused by Streptococcus pneumoniae: a case report and review of the literature].

We report a case of hematogenous streptococcus pneumoniae infection of a total knee arthroplasty observed in an 82-year-old woman who initially presented a lung infection. The therapeutic approach was largely dictated by the patient's precarious general status. Arthroscopic washings were associated with adapted antibiotics followed by removal of the prosthesis and replacement with a spacer.